Almost forty years have passed since the 1978 birth of Louise Brown – the first IVF baby – launched a revolution in reproductive medicine resulting in over 250,000 births in the UK alone. This event, organised as part of the Manchester Science Festival programme, sought to inform and engage the public on recent developments in the field that have tested and continue to test ethical and legal boundaries, namely: research on human embryos, genome editing, and mitochondrial replacement therapy (MRT).
Roger Highfield, Director of External Affairs at the Science Museum Group, introduced the three speakers for the evening: Dr Marta Shahbazi, a member of the research team led by Professor Magdalena Zernicka-Goetz at the University of Cambridge, Dr Norah Fogarty, a member of the research team led by Dr Kathy Niakan of the Francis Crick Institute in London and Professor Sir Doug Turnbull, Director of the Wellcome Trust Centre for Mitochondrial Research in Newcastle-upon-Tyne.
Dr Shahbazi was the first to present a brief explanation of a new technique that allows embryos to develop in vitro beyond the implantation stage (day six of embryo development) (see BioNews 850). Dr Shahbazi reflected on what scientists had learned thus far, reporting that human embryos appear to have an intrinsic capability for self-organisation, at least until day 13. Scientists had previously been unable to analyse the key stages of development beyond this point, a period known as the 'black box' of development.
Dr Fogarty then presented the research of the team at the Francis Crick Institute which seeks to define the molecular mechanisms underlying human preimplantation development by using CRISPR/Cas9 to inactivate key genes (see BioNews 919). Dr Fogarty began by presenting the audience with a background to genome editing in layman's terms, explaining that researchers are currently studying the protein OCT4. Researchers observed the development of an edited embryo (where OCT4 had been inactivated) compared with an unedited control embryo in time-lapse videos presented to the audience. Their observations suggested that OCT4 is fundamental to the proper development of human blastocysts.
Finally, Professor Turnbull provided a cogent explanation of the purpose of MRT research, explaining what mitochondrial disease is and what its outcomes are, while presenting the audience with a graphic illustrating mitochondrial donation by pronuclear transfer. In March 2017, the Wellcome Trust Centre for Mitochondrial Research in Newcastle was granted the first UK licence to carry out mMRT (see BioNews 893). Professor Turnbull reported plans for a study to look at the developmental outcome of children born using MRT at 18 months, explaining that MRT is not an IVF technique, but rather 'a pathway of care'.
After each of the presentations on current research, Roger Highfield chaired a discussion with the panel on issues ranging from the legacy of Steptoe and Evans' scientific achievement to larger questions of when personhood begins and reflections on the next milestones for each of the developments discussed.
The panel unanimously agreed with Professor Turnbull that the legacy of Louise Brown's birth was not only hope for large numbers of infertile women, but that the inception of IVF in the UK also paved the way for regulation in the form of the Human Fertilisation and Embryology Act (HFEA) 1990 (as amended) following the 1984 Warnock Report.
On the question of life and personhood, Dr Shahbazi explained that day 14 of embryo development is the point at which the primitive streak begins to emerge – the first structure in the embryo when cells begin to specialise into neurons or muscle cells. It is also the point at which an embryo can no longer split to give rise to twins, and is currently recognised both nationally and internationally as the ethical (and legal) limit for the culture of human embryos (see BioNews 883).
In terms of the next milestone projections, Professor Turnbull emphasised that scientists and clinicians working in the area of MRT want to be able to provide reproductive choice for families within the limits that society permits. Dr Fogarty explained that genome editing is a powerful tool enabling us to study any gene in the human embryo, and further research is needed to understand human development. Similarly, Dr Shahbazi said that researchers hope to better analyse and understand embryo development and the causes of early pregnancy loss.
The floor was then opened to the audience for comments and questions. Topics ranged from scientists' use of animal models in experiments, to enhancement in genome editing and so-called designer babies, to what experiments the panel would carry out if regulatory restrictions could be ignored (although all agreed they were happy to work within the regulations, as there is still much research to be done within these parameters), the issues of cost in a public-funded healthcare system, and the possibility of artificial embryos moving forward.
Overall, the event provided a valuable opportunity for individuals to learn about and discuss topical issues of public importance. I found it highly interesting and felt it presented a digestible explanation of the science, as well as the legal and ethical issues involved in each of the developments explored, allowing the public to easily engage.